30-Day Post-Discharge Prophylaxis with Rivaroxaban Prevents Porto-mesenteric Venous Thrombosis Following Laparoscopic Sleeve Gastrectomy.

Introduction: Porto-mesenteric venous thrombosis (PMVT) is a significant complication that occurs more frequently after laparoscopic sleeve gastrectomy (SG) than other bariatric procedures and presents later than other venous thromboembolic (VTE) events often 2 weeks after the operation. The common current practice in bariatric surgery of perioperative chemoprophylaxis until discharge may not adequately prevent PMVT. Therefore, a 30-day post-discharge chemoprophylaxis (PDC) might reduce the incidence of PMVT.

Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain.

Background: To determine, in a private practice, whether symptomatic bile reflux can occur after Roux-en-Y gastric bypass (RYGB) for morbid obesity and the outcome after laparoscopic alimentary (Roux) limb lengthening. Bile reflux as a cause of pain after laparoscopic RYGB has not been previously described. We report on a series of patients with chronic pain after RYGB as a result of bile reflux owing an abnormally short alimentary limb.

Anastomotic stenosis after Roux-en-Y gastric bypass: A rational approach to treatment.

Background: Anastomotic stenosis, a common sequela to Roux-en-Y gastric bypass, has a reported incidence of 1.6-27% and recurs in 17-33%. No universal guidelines for optimal treatment exist.

Elective cholecystectomy after Roux-en-Y gastric bypass: why should asymptomatic gallstones be treated differently in morbidly obese patients?

Background: Gallbladder management in bariatric surgery varies. Some surgeons perform routine cholecystectomy with bariatric surgery, and others selectively base that decision on routine preoperative ultrasound findings. Both approaches treat bariatric patients differently than the normal-weight population in whom cholecystectomy is not performed in asymptomatic patients.

Acute mesenteric venous thrombosis following laparoscopic Roux-en-Y gastric bypass.

Background And Objectives: Acute mesenteric venous thrombosis has not been previously reported as a complication following Roux-en-Y gastric bypass.

Methods: The authors present 3 cases from a single-center experience of over 1500 patients as well as a review of the literature.

Results: The presenting symptoms are nonspecific, and the diagnosis is often made after infarction of the intestine has occurred.

Conversion of laparoscopic Roux-en-Y gastric bypass.

Background: To determine the incidence and causes of conversion from a laparoscopic to an open gastric bypass for morbid obesity, we reviewed the experience of our bariatric center.

Methods: We performed a retrospective review of the records of consecutive patients undergoing laparoscopic Roux-en-Y gastric bypass at our center.

Results: In all, 1,236 consecutive patients with body mass indes (BMI) from 35 to 82 were approached laparoscopically.